More Vegetables and Better Diets in Rwanda

In Rwanda earlier this summer, I visited a rural project with the
lyrical name, IBYIRINGIRO. It means “hope” in Kinyarwanda, and trumpets
this slogan: “That in which we have faith for a better tomorrow.”

The
“that” in which Ibyiringiro puts its faith is better nutrition. Better
nutrition for a better tomorrow. It is a message carried by neighborhood
health workers and put into practice through community-based nutrition
education, the promotion of vegetable gardens, and cooking
demonstrations that draw big, curious crowds. It began as a program for
people living with HIV/AIDS, but the Ibyiringiro philosophy spreads
through entire communities.

“We were finding households with
enough food but the children were malnourished,” said Erisa Mutabazi,
the manager of the Ibyiringiro project for World Vision in Rwanda. “They
might have a lot of food, but they didn’t know how to balance it. They
would eat only one type of food during a season.”

“More often than not here,” he said, “food insecurity is not caused by lack of food but poor utilization of available food.”

This
important revelation will appropriately be at the center of this week’s
deliberations on reducing poverty and hunger when the United Nations
examines the progress—or lack of it—on achieving the Millennium
Development Goals by the target date of 2015. It will be the particular
focus of Tuesday’s special U.S.-Irish initiative to highlight
undernutrition as one of the world’s most serious but least addressed
problems.

That event, hosted by U.S. Secretary of State Hillary
Clinton and Ireland’s Minister for Foreign Affairs, Micheal Martin, will
launch “1,000 Days: Change a Life, Change the Future—Partnering to
Reduce Child Undernutrition.” It is intended to lead a movement to
improve child nutrition through programs targeted at the 1,000 days
window of opportunity, beginning with a woman’s pregnancy and continuing
until a child is 2 years old.

These early days of a child’s
development are crucial in combating physical and mental stunting.
Development agencies have built an amazing network of school feeding
programs in the poorest countries; these programs ensure that
school-aged children get at least one hot meal a day, and they provide
encouragement for parents to enroll their children in school and
incentive to local farmers to grow food for the school meals. But
nutrition programs for pre-school children have been less widely
developed.

The malnutrition that results from a lack of vital
micronutrients—vitamin A, iron, zinc, and many, many others—is often
called “hidden hunger,” because it may not be manifested so clearly as
hunger from a lack of food. Still, this hidden hunger has left 150
million children under the age of 5 stunted from malnourishment, which
means they likely never will reach their full potential, physically or
mentally.

Part of the hidden nature of malnourishment is that it
is often overlooked in the talk of food security. The emphasis has
usually been on boosting production of food, not necessarily on
improving the nutrition of that food as well. Unfortunately, food and
nutrition have often been decoupled: food being the realm of ministries
of agriculture; nutrition the realm of ministries of health.

This
separation hindered the treatment of HIV/AIDS in Africa; the continent
sits at the deadly crossroads of the highest prevalence of AIDS and the
highest prevalence of chronic hunger. The early efforts to combat AIDS
focused on the need to get affordable medicine into Africa; the
provision of nutritious food to compliment the medicine was nowhere to
be found in the international AIDS treatment protocol. That only began
to change when doctors in the field (most notably in the AMPATH program
in Kenya, which is featured in our book Enough) began noticing
that some patients weren’t responding as well as they should to the
HIV/AIDS medicine. It turned out they didn’t have enough food to eat;
unable to work their fields, isolated from their families, they were
chronically hungry.

African ministers of health appealed to
international donors to begin funding food and nutrition programs as
well as supplying medicine. They argued that giving such drugs to hungry
people was like washing your hands and then drying them in the dirt.
What good did it do?

In the past couple of years, nutrition has become an important component of HIV/AIDS treatment.

Likewise,
in all the attention on food security, an increase in food production
won’t be victory enough. There must also be improvement in the variety
of crops, and the nutritional value of the food, as well.

This
dual necessity is at the heart of Ibyiringiro. The program is funded by
the U.S. Agency for International Development and PEPFAR (the
President’s Emergency Plan for AIDS Relief, begun by President George W.
Bush) and implemented by a consortium of humanitarian agencies
including Catholic Relief Services, World Vision, Africare, ACDI/VOCA,
and Adventist Development and Relief Agency.

Some of these
agencies were monitoring child growth patterns five years ago and found
that malnutrition rates were running up to 45 percent among children
under 5 in the area.

“It was a shock to see families that were
food secure but still malnourished,” said World Vision’s Mutabazi.
“Traditionally they just ate beans or potatoes. We would look in the
houses and they would have carrots, onions, other vegetables, but they
wouldn’t eat them. They would sell them.”

In Ibyiringiro, they
beseech the farmers not to sell all the vegetables, but to keep a
variety of their crops in stock and eat them through the year, mixing
them with the staples. They teach a new technique of growing a variety
of vegetables on a small piece of land near the house, called
bio-intensive gardening. And they organize cooking classes, about how to
mix vegetables with the staple foods, and the importance of adding fish
and other proteins to the diet. The malnutrition rate among children in
the area has fallen to 12 percent.

The day I visited, villagers
gathered under a mango tree for a cooking demonstration. The instructors
displayed photos of various vegetables and their nutritional
components. In a big bowl, they mixed bananas, beans, sweet potatoes,
cassava, collard greens, peanuts and vegetable oil. It was the day’s
lunch, served with tiny sardine-like fish from the local lakes. For
dessert there was pineapple, papaya and mango, all of which grow wild in
the area.

“How’s it taste?” I asked the group.

“Delicious,” came a loud chorus.

“I
used to just make potatoes. They are filling. I didn’t know what was
nutritious,” volunteered one woman. “I didn’t understand. I thought
every type of food had all the nutrition.”

Not far from the mango
tree, Frank Bitwayiki showed off his little garden right beside his
mud-brick house. He was growing onions, eggplant, carrots and cale.

“I
never ate vegetables with regularity,” he said. “I never planted any.”
He grew the staple crops: beans, potatoes, maize, cassava. And he would
rarely pick any of the tomatoes, onions and peppers that would grow wild
in the fields. When the Ibyiringiro instructors first came to his
village to talk about gardens, he wasn’t interested. “I thought it was a
waste of time,” Frank said.

Then three years ago he planted his
first garden, and he grew convinced about the importance of vegetables
as he saw his family’s health improve. He says his two children, 8 and 5
years old, have grown strong with more nutritious diets.

Do they like vegetables?

“Yes, very much,” Frank said, smiling broadly.

He
is the president of the community association, and he leads by example.
He reported that of the 246 members, 170 have followed him in starting a
kitchen garden.

The name of the association is “Let’s Look Forward.”

Roger Thurow’s blog post appears courtesy of the Global Food for
Thought blog.
Thurow, a former Wall Street Journal correspondent, is a senior
fellow for Global Agriculture and Food Policy at The Chicago Council on
Global Affairs.

Thanks for the info Roger. For some reason I thought it is obvious tha ALL farmers grow their food, because they are connected to mother-earth and know how to and how good it is to eat your own. It was quite surprising to read this.
Thanks for sharing.
ido

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